TITLE:
Submental Intubation with LMAFastrachTM Endotracheal Tube in Maxillofacial Trauma: A Case Report
AUTHORS:
Daphne Moo, Elizabeth Tan, Juen Bin Lai, Soo Toon Chan
KEYWORDS:
Submental Intubation, LMAFastrachTM, Maxillofacial Trauma
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.9 No.12,
December
12,
2019
ABSTRACT: Securing a definitive airway in patients who require surgical fixation of complex maxillofacial fractures is an integral part of their perioperative management. For the ease of surgical access, an orotracheal tube is usually not preferred by surgeons. The presence of a base of skull or nasal bone fractures would also contraindicate nasotracheal intubation. Therefore, a tracheostomy may be the only option left to secure the airway in these patients who require surgical fixation. Submental intubation has been used as a safe and effective alternative method in patients who require intubation for maxillofacial reconstruction since it was first reported by Hernandez Altemir F in 1986. Many modifications to the original technique have been documented over the years, but there has been no consensus to support the use of a single method or device. In this case report, we described our experience with submental intubation using an LMAFastrachTM endotracheal tube (ETT) to facilitate the surgical fixation of bilateral Le Fort II fractures. We conclude that the LMAFastrachTM ETT is a suitable device for submental intubation. This technique should be included in airway workshops and courses for anaesthesia residents as it is a simple yet secure alternative to tracheostomy in the intraoperative airway management of maxillofacial trauma.